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-
1.
Carapetis JR et al. 2016. Acute rheumatic fever and rheumatic heart disease. Nat Rev Dis Primers 2: 15084.
-
2.
Coffey PM , Ralph AP , Krause VL , 2018. The role of social determinants of health in the risk and prevention of group A streptococcal infection, acute rheumatic fever and rheumatic heart disease: a systematic review. PLoS Negl Trop Dis 12: e0006577.
-
3.
Australian Health Ministers’ Advisory Council , 2017. Aboriginal and Torres Strait Islander Health Performance Framework 2017 Report. Canberra, Australia: Australian Health Ministers’ Advisory Council.
-
4.
Ralph AP , Noonan S , Wade V , Currie BJ , 2020. The 2020 Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. Med J Aust 2020 Nov 15. doi: 0.5694/mja2.50851.
-
5.
Torres Strait Islander Regional Council , 2016. Culture, Protocols and Heritage. Available at: www.tsirc.qld.gov.au/our-communities/culture-protocols-heritage. Accessed June 1, 2020.
-
6.
Remenyi B et al. 2012. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease--an evidence-based guideline. Nat Rev Cardiol 9: 297–309.
-
7.
Carapetis J et al. 2012. The Australian Guideline for Prevention, Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease, 2nd edition. Darwin, Australia: RHD Australia. Available at: https://researchers.cdu.edu.au/en/publications/the-australian-guideline-for-prevention-diagnosis-and-management.
-
8.
Australian Bureau of Statistics , 2016. 2016 Census. Available at: https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/POA4875. Accessed November 11, 2020.
-
9.
Davis K et al. 2018. Rheumatic heart disease in Timor-Leste school students: an echocardiography-based prevalence study. Med J Aust 208: 303–307.
-
10.
White H , Walsh W , Brown A , Riddell T , Tonkin A , Jeremy R , Brieger D , Zeitz C , Kritharides L , 2010. Rheumatic heart disease in indigenous populations. Heart Lung Circ 19: 273–281.
-
11.
Francis JR et al. 2020. Hyperendemic rheumatic heart disease in a remote Australian town identified by echocardiographic screening. Med J Aust 213: 118–123.
-
12.
■ , 2007. Why are medical practitioners in north Queensland missing cases of acute rheumatic fever? Trop Popul Health Unit Netw Commun Dis Control Newsl 55: 1–4.
-
13.
Wu J , Taylor D , Ovchinikova L , Heaney A , Morgan T , Dartnell J , Holbrook R , Humphreys L , Weekes L , Blogg S , 2018. Relationship between antimicrobial-resistance programs and antibiotic dispensing for upper respiratory tract infection: an analysis of Australian data between 2004 and 2015. J Int Med Res 46: 1326–1338.
-
14.
Tarca AJ , Hand RM , Wyber R , 2019. Call for a national sore throat guideline. Med J Aust 210: 477–477.e1.
-
15.
Parks T , Smeesters PR , Steer AC , 2012. Streptococcal skin infection and rheumatic heart disease. Curr Opin Infect Dis 25: 145–153.
-
16.
McDonald MI , Towers RJ , Andrews RM , Benger N , Currie BJ , Carapetis JR , 2006. Low rates of streptococcal pharyngitis and high rates of pyoderma in Australian aboriginal communities where acute rheumatic fever is hyperendemic. Clin Infect Dis 43: 683–689.
-
17.
Guthridge I , Smith S , Horne P , Hanson J , 2019. Increasing prevalence of methicillin-resistant Staphylococcus aureus in remote Australian communities: implications for patients and clinicians. Pathology 51: 428–431.
-
18.
Nofz L , Koppen J , De Alwis N , Smith S , Hanson J , 2019. The microbiology of ear cultures in a high-burden setting in tropical Australia: implications for clinicians. Clin Otolaryngol 44: 1195–1200.
-
19.
Smith S , Russell D , Horne P , Hanson J , 2019. HTLV-1 is rare in Far North Queensland despite a significant burden of classically associated diseases. Pathology 51: 91–94.
-
20.
Australian Bureau of Statistics , 2018. Labour Force, Australia. Available at: https://www.abs.gov.au/ausstats/abs@.nsf/lookup/6202.0Media%20Release1Jun%202018. Accessed November 24, 2020.
-
21.
Australian Bureau of Statistics , 2016. Census of Population and Housing: Socio-Economic Indexes for Areas, Australia. Available at: https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/2033.0.55.001∼2016∼Main%20Features∼What%20is%20SEIFA%3f∼8. Accessed June 1, 2020.
-
22.
Kang K , Chau K , Howell E , Anderson E , Smith S , Davis T , Starmer G , Hanson J , 2020. The temporospatial epidemiology of rheumatic heart disease in Far North Queensland, tropical Australia 1997–2017; impact of socioeconomic status on disease burden, severity, and access to care. PLoS Negl Trop Dis, In press.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 941 | 191 | 58 |
| Full Text Views | 350 | 161 | 3 |
| PDF Downloads | 289 | 116 | 5 |
Echocardiographic Screening Detects a Significant Burden of Rheumatic Heart Disease in Australian Torres Strait Islander Children and Missed Opportunities for its Prevention
Allison Hempenstall
Allison Hempenstall
Torres and Cape Hospital and Health Service, Thursday Island, Australia;
James Cook University, Cairns, Australia;
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James Cook University, Cairns, Australia;
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Erin Howell
Erin Howell
Cairns Hospital and Hinterland Health Service, Cairns, Australia;
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Katherine Kang
Katherine Kang
Cairns Hospital and Hinterland Health Service, Cairns, Australia;
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Ken W. T. Chau
Ken W. T. Chau
Cairns Hospital and Hinterland Health Service, Cairns, Australia;
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Amylou Browne
Amylou Browne
Torres and Cape Hospital and Health Service, Thursday Island, Australia;
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Ella Kris
Ella Kris
Torres and Cape Hospital and Health Service, Thursday Island, Australia;
James Cook University, Cairns, Australia;
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James Cook University, Cairns, Australia;
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Hylda Wapau
Hylda Wapau
Torres and Cape Hospital and Health Service, Thursday Island, Australia;
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Pelista Pilot
Pelista Pilot
Torres and Cape Hospital and Health Service, Thursday Island, Australia;
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Simon Smith
Simon Smith
Cairns Hospital and Hinterland Health Service, Cairns, Australia;
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Benjamin Reeves
Benjamin Reeves
Cairns Hospital and Hinterland Health Service, Cairns, Australia;
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Josh Hanson
Josh Hanson
Cairns Hospital and Hinterland Health Service, Cairns, Australia;
The Kirby Institute, Sydney, Australia
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The Kirby Institute, Sydney, Australia
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ABSTRACT
Rheumatic heart disease (RHD) is almost entirely preventable, but its incidence in indigenous Australians remains one of the highest in the world. A community-based echocardiogram screening program of 862 Torres Strait Islander children identified 25 (2.9%) new cases of RHD. Among these 25 children, 5/7 (71%) prior acute rheumatic fever presentations had not been recognized. There was a history of microbiologically confirmed group A Streptococcus infection in 17/25 (68%) children with RHD compared with 9/25 (36%) controls (odds ratio [OR] [95% CI]: 3.78 [1.17–12.19], P = 0.03). This was more likely to be a skin swab (16/25 [64%] cases versus 6/25 [24%] controls) than a throat swab (1/25 [4%] cases versus 3/25 [12%] controls) (OR [95% CI]: 5.33 [1.51–18.90] [P = 0.01]), supporting a role for skin infection in RHD pathogenesis. Household crowding and unemployment were common in the cohort, emphasizing the need for prioritizing strategies that address the social determinants of health.
Author Notes
Authors’ addresses: Allison Hempenstall, Amylou Browne, Ella Kris, Hylda Wapau, and Pelista Pilot, Torres and Cape Hospital and Health Service, Thursday Island, Australia, E-mails: allison.hempenstall@health.qld.gov.au, amylou.browne@health.qld.gov.au, ella.kris@tsirc.qld.gov.au, hylda.wapau@health.qld.gov.au, and pilotpel06@gmail.com. Erin Howell, Katherine Kang, Ken W. T. Chau, Simon Smith, and Benjamin Reeves, Cairns Hospital and Hinterland Health Service, Cairns, Australia, E-mails: erinhowell21@gmail.com, katherine.kang@health.qld.gov.au, ken.chau@health.qld.gov.au, simon.smith2@health.qld.gov.au, and benjamin.reeves@health.qld.gov.au. Josh Hanson, The Kirby Institute, University of New South Wales, Kensington, Sydney, Australia, E-mail: jhanson@kirby.unsw.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Carapetis JR et al. 2016. Acute rheumatic fever and rheumatic heart disease. Nat Rev Dis Primers 2: 15084.
-
2.
Coffey PM , Ralph AP , Krause VL , 2018. The role of social determinants of health in the risk and prevention of group A streptococcal infection, acute rheumatic fever and rheumatic heart disease: a systematic review. PLoS Negl Trop Dis 12: e0006577.
-
3.
Australian Health Ministers’ Advisory Council , 2017. Aboriginal and Torres Strait Islander Health Performance Framework 2017 Report. Canberra, Australia: Australian Health Ministers’ Advisory Council.
-
4.
Ralph AP , Noonan S , Wade V , Currie BJ , 2020. The 2020 Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. Med J Aust 2020 Nov 15. doi: 0.5694/mja2.50851.
-
5.
Torres Strait Islander Regional Council , 2016. Culture, Protocols and Heritage. Available at: www.tsirc.qld.gov.au/our-communities/culture-protocols-heritage. Accessed June 1, 2020.
-
6.
Remenyi B et al. 2012. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease--an evidence-based guideline. Nat Rev Cardiol 9: 297–309.
-
7.
Carapetis J et al. 2012. The Australian Guideline for Prevention, Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease, 2nd edition. Darwin, Australia: RHD Australia. Available at: https://researchers.cdu.edu.au/en/publications/the-australian-guideline-for-prevention-diagnosis-and-management.
-
8.
Australian Bureau of Statistics , 2016. 2016 Census. Available at: https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/POA4875. Accessed November 11, 2020.
-
9.
Davis K et al. 2018. Rheumatic heart disease in Timor-Leste school students: an echocardiography-based prevalence study. Med J Aust 208: 303–307.
-
10.
White H , Walsh W , Brown A , Riddell T , Tonkin A , Jeremy R , Brieger D , Zeitz C , Kritharides L , 2010. Rheumatic heart disease in indigenous populations. Heart Lung Circ 19: 273–281.
-
11.
Francis JR et al. 2020. Hyperendemic rheumatic heart disease in a remote Australian town identified by echocardiographic screening. Med J Aust 213: 118–123.
-
12.
■ , 2007. Why are medical practitioners in north Queensland missing cases of acute rheumatic fever? Trop Popul Health Unit Netw Commun Dis Control Newsl 55: 1–4.
-
13.
Wu J , Taylor D , Ovchinikova L , Heaney A , Morgan T , Dartnell J , Holbrook R , Humphreys L , Weekes L , Blogg S , 2018. Relationship between antimicrobial-resistance programs and antibiotic dispensing for upper respiratory tract infection: an analysis of Australian data between 2004 and 2015. J Int Med Res 46: 1326–1338.
-
14.
Tarca AJ , Hand RM , Wyber R , 2019. Call for a national sore throat guideline. Med J Aust 210: 477–477.e1.
-
15.
Parks T , Smeesters PR , Steer AC , 2012. Streptococcal skin infection and rheumatic heart disease. Curr Opin Infect Dis 25: 145–153.
-
16.
McDonald MI , Towers RJ , Andrews RM , Benger N , Currie BJ , Carapetis JR , 2006. Low rates of streptococcal pharyngitis and high rates of pyoderma in Australian aboriginal communities where acute rheumatic fever is hyperendemic. Clin Infect Dis 43: 683–689.
-
17.
Guthridge I , Smith S , Horne P , Hanson J , 2019. Increasing prevalence of methicillin-resistant Staphylococcus aureus in remote Australian communities: implications for patients and clinicians. Pathology 51: 428–431.
-
18.
Nofz L , Koppen J , De Alwis N , Smith S , Hanson J , 2019. The microbiology of ear cultures in a high-burden setting in tropical Australia: implications for clinicians. Clin Otolaryngol 44: 1195–1200.
-
19.
Smith S , Russell D , Horne P , Hanson J , 2019. HTLV-1 is rare in Far North Queensland despite a significant burden of classically associated diseases. Pathology 51: 91–94.
-
20.
Australian Bureau of Statistics , 2018. Labour Force, Australia. Available at: https://www.abs.gov.au/ausstats/abs@.nsf/lookup/6202.0Media%20Release1Jun%202018. Accessed November 24, 2020.
-
21.
Australian Bureau of Statistics , 2016. Census of Population and Housing: Socio-Economic Indexes for Areas, Australia. Available at: https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/2033.0.55.001∼2016∼Main%20Features∼What%20is%20SEIFA%3f∼8. Accessed June 1, 2020.
-
22.
Kang K , Chau K , Howell E , Anderson E , Smith S , Davis T , Starmer G , Hanson J , 2020. The temporospatial epidemiology of rheumatic heart disease in Far North Queensland, tropical Australia 1997–2017; impact of socioeconomic status on disease burden, severity, and access to care. PLoS Negl Trop Dis, In press.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 941 | 191 | 58 |
| Full Text Views | 350 | 161 | 3 |
| PDF Downloads | 289 | 116 | 5 |